HomeMy WebLinkAbout2015-00647 - addn/remodel/repair � � CITY OF ORONO * 2 0 1 S - 0 0 6 4 7 *
2750 KELLEY PARKWAY DATE ISSUED: 05/26/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2980 CASCO POINT RD
PIN : 20-117-23-31-0061
LEGAL DESC : REG. LAND SURVEY NO. 1423
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENT[AL
VALUATION : $ 15,000.00
NOTE: PRIOR TO RELEASE OF ESCROW MONEY,AN AS-BUILT SURVEY AND HARDCOVER CALCULATIONS MUST BE SUBMITTE�
AND APPRQVED.
INITIAL: ��--
APPLICANT PERMIT FEE SCHEDULE 278.81
PLAN REVIEW 181.23
MILLER,JONATHAN&AMY STATE SURCHARGE(VALUATION) 7.50
2980 CASCO POINT RD.
WAYZATA, MN 55391- TOTAL 467.54
Payment(s)
CHECK 2148 467.54
OWNER
MILLER,JONATHAN&AMY
2980 CASCO POINT RD.
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
—7 /
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A icant Pe tee Signature Date [ssue By Signature Date
�g
CITY OF ORONO 2�
BUILDING PERMIT APPLICATION �,�
FOR NEW STRUCTURES OR ADDITIONS
�Q j _ f 4 Mailing Address: Permit number: ��`c�'��
1VO t' 1' CrysBtal Bay, MN 55323-0066 Date received: ' � " �
�n �p`;' Received by:
� Street Address:�
�`{ �
y � _1 2750 Kelley Parkway Plan review fee:
��"�kESNO��� Orono, MN 55356 `
Main: 952-249-4600 Total Fee: �
Fax: 952-249-4616 www.ci.orono.mn.us u
This application form must be completed in full and all required information must be submitted. �/�(�lVtO�"�
incomplete applications will be returned. (Please print)
GENERAL INFORMATION;�.� .f � � <� �� ��� � '`� � �,�-,-, �. ,� ` ��,� ;��-�,� 4
�:. � ��
Job Site Address: �' ` f� '
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wiU be
required unless applicant demonstrates sufficrent on-site parking is available. IVon-permitted events witl not be aJlowed.
CONTRACTOR I APPLICANT INFORMATION:
Name: �:��'i ����,��C�'
State License# � Expiration Date:
Phone: (cell) 2� t� c ���`�1 �� 7 7' � (office)
,� ..r '' � �°`v�-�-� City: �:���*_4-� ZIP. ..� �">�k f
Mailing Address: �2��-== ���-�� �'T �`�� -
Contact Person: Applicant is: Contractor / Homeowner (Circle One}
Email and/or Fax: `..�,• �/` ' ``'� �'".�^��� . �°�-*
PROPERTY OWNER INFORMATION: ,�7 ,i
Name: '`� ---- :.._ � ' i'�'�-
Phone(day}: � � `�' `
Address: City: ZIP: _
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of pro�ect:��� `������ ��'�'�1
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction �(Single Family with ❑Accessory Bldg./Garage
ddition attached garage �Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wail(s)
❑ Public 4-feet or greater ❑ Public Water
**Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review&permits. ❑Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑Other: (specify) ❑ Other(specify)
15320 Minnetonka Bivd ���
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
� ���� �. � �
Estimated Construction Valuation (excluding land) �'
�
Last Updated: January 2015
STRUCTURE INFORMATION:
1.Structure Dimensions : ,� 1.Structure Dimensions(continued) 2.Type of Construction
a. Length (ft.)= �� �` ;�� Number of bedrooms= j�Wood/Frame
b.Width(ft.)= �1� `� Number of garage stalis: ❑ Masonry
.�...7�� ;�� �� ,� ❑ Metal
Areas in sauare feet`� K '` Attached=
� G`t ❑ Pole Bidg.
a Basement= Detached = ❑ ICF
d. 15�Story = ❑ On-site Prefab
e.2"d Story= ❑ Off-site Prefab
f. YZ Story = ❑Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
Alt of the information must be submitted in order for your application to be proc�ssed:
Not
Enclosed Ap licable
p ❑ Buildin Permit Escrow A reement and Fees
❑ ❑ Plan Review Fee
,p-�- ❑ Com leted A lication Form
„�.-° ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set
❑ _,@~ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
❑ ❑ Surve —2 full size,to scale meetin ALL surve re uirements)
�°°' ❑ Hardcover Calculations
❑ Se tic S stem Certification
❑ Minnehaha Creek Watershed District(MCWD)Permit or
Documentation from MCWD statin no ermit is re uired
❑ Landsca e Walls and/or Retainin Wall Plans
❑ Stormwater Pollution Prevention Plan SWPPP
❑ Access Permit
❑ ,�' Data Privacy Advisory Form
APPLICANT/OWNER ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consultant review costs in excess of$500;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Acknowledges the Escrow Agreement is completed and signed;
• Understands some or all of the information that you are asked to provide on this application is classified by State law as either
private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject
of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use of this information is to annualfy update our records and records of other governmental agencies
required by law. If you refuse to supply the information,the application may not be issued.
• Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Gertificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a 510,000
escrow to ensure completion o#the as-built survey and all site improvements. �
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_ ___. � 1 _ � �
ApplicanYs Signature. Date: -
`�. �,�2 ��- Date: ��
Owner's Signature:
Last Updated: January 2015
' � P'LAN R�VIE�iIV CH�C�°CLIST FC)R �EIIV STRE�CTURES / 14�DiTIOIVS
Address. ���� �� ���� Rerrnit No.:_ ��� ' ��
De�cription of work: � Date Rec'd: � `�� �
Septic review by: �"�" Date Approved:
�• �
Zoning review by: Date Approved: °��',��
,
�uilding r�view by: �� � Date Approved: '� "��~� � � ����
Grading review by: � Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
� Zoning: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey Sutamitted: �Yes ❑ No Date of Sunrey: Revised date(?):
Proposed Setbacks:
� F�ht(Lake)" J. Rear(�tteet) ( N S E W ) ( t� S: E W ) Other Buildings Wetiand
�rde �ide
Defir�ed Height: Peak Fieight: FFE: FFE minus 6 feet= (Existing Contour)
Perimefer(linear feet� = 50%= L.F. below grade #of Stories
'�; FOR A BUILDItJG WITH A BASEtdENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed The distance between the top of
START WITH floor(of the basement or crawl space)and START WITH slab and the highest point of the
the highest point of the roof. roof.
If you have a. . If you have a...
6� GABLE OR HIPPED ROOF(no • GABLE OR IPPED ROOF
z ` (no wi s: Subtrect half
windows): Subtract half the distance distance between the
between the highes oint of the roof highest point of the roof to
to the low poi the corresponding
SUBTR,4CTION gable o ' ped roof / the low point of the
corresponding gable or
(BASED ON � LE OR HIPPED ROOF(with SUBTRA�T'(ON hipped roof
ROOF TYPE) windows): Subtract half the distance (BASE,I3 ON • GABLE OR HIPPED ROOF
between the top of the highest R0.C3F TYPE) (with windows): Subtract
window and the highest point of the half the distance between
roof the top of the highest
�� / • ALL OTHER ROOF TYPES(flat, ��� window and the highest :
point of the roof
mansard,etc):No subtraction. - . ALL OTHER ROOF TYPES
SUBTRACTION Subtract the distance between the (flat,mansard,etc):No
(BASED ON basemenUcrawl space floor and the subtraction.
/ EXISTING highest existing grade adjacent to the ADDITION Add the distance between the top
GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing
EQUALS Def�ned building height EXISTING grade adjacent to the foundation.
GRADES
EQUALS Defined building height
Shoreland District MCV19D Permit �verage Lakeshore Setback Bluff
Nlet?
' �t�pYes 0 No Permit Number. C� Yes � No � N/A � Yes ❑ No
❑ N/A—see attached Setback:
Stormwater Quality �xisting Hardcover Praposed
Overlay District (%and sf} Hardcoder Variance Required CllP Required
Tier circle one %and s
� ' � Yes , i� No � Yes C7 No
1 2 3 4 5 Type(s): Type(s):
Updated: January 2015
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REMARKS (in-house):
Fees to be Char ed YES NO
Permit
* Plan Review
State Surcharge �
Investigation Fee �
t
SAC—Nur�nber of 3AC Units
Other(specify)
Square Foota e $ per Square Foota e
Basement X = $
15t Floor X = $
2nd FIOOf X = �
Garage X = $
Estimated Construction Value: � ��;�,��� ��
' Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading/ Fi►fing � Well
� Silt Fence/ Erosion Control � Mechanical 0 Fire ❑ Electrical
� Hardcover Removal � Septic 0 Water Connection
Footing 0 Fireplace � Sewer Connection
4 ❑ Poured Wall Q Masonry 0 Lawn Irrigation
0 Foundation Surve�r � Mfg. a Landscaping
b' ❑ Foundation Waterproofing � Ofher(specify)
� Radon Rock Bed
Framing
�; ❑ Insulation
Built Survey
Final
� Other(specify)
:
REMARKS (in-house):
Qther Review: Reviev�red by: Date Approved:
Access: Existing: � YES 0 NO New: � YES ❑ NO
OFF CIAL REMARKS -TO BE N ED ON PERMIT AND tNITIALLED
� -�E �`i � � Y{. � A ��t �
�- �,.�I� L�� C.�t��,�,(.�.f�v� �� �ccbvn�� �- ��vtd.
Updated: January 2015
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� City of Orono
;:�o;;;�, Hardcover Calculation Worksheet
o �,
i� . �� Property Address: 2 F Sp CAJ'C4 �°�'��"�''� R�Ae�' {,��,,r,��� ��4G�'R�
`��f c Date.
�•�4E5„_�,•,� Prepared by: GxO�BE",�� r� �(PI'aC/,�TE1',/�s/C. 6-6•tY CF�'�w� 6-Zo i�s4�ve
Stormwater Quality Overlay District 7ier: (Circle one) Tier �I Tier 2 Tier 3 Tier 4 Tier 5
Step 1: EXISTING HARDCOVER
In the following table identify all items af existing hardcwer on the praperty,keyed by letter to Certificate
of SLivey(survey must accompany this form). Use as many lines as necessary to accurately depict
exis�ng hardcover status crf the properry. For Tier 1 properties,identify any features by letter which are
split at the 75' setback line and calculate hardcover square foatage separately for��To al'on
Key to Hardcover Item (Describe) Length x wdth �S uare Feet)
Surve 720 S.F.
• 24'x 30'
Exam Is �ara e S.F.
a au s.F.
B / 9 S.F.
� S�D Y.c. (f 2 S.F.
D �' S f ''� S.F.
E .v E: r� 7 S.F.
F � � S.F.
G S.F.
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p Y S.F.
Q S.F.
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T V S.F.
U S.F.
V S.F.
W S.F.
X S.F.
Y S.F. �
Z �" S.F.
1 Total Existin Hardcover
Excludable Hardcover See C' Code Sec 78 1684 : S.F.
,f.l,/ � S.F.
S.F.
. S.F.
S.F.
, S.F. . _�
2 Total Excludable Hardcover g F
3 Net Exis6n Hardcover Subtract line{2 from line 1 �•"
T .eD. �ut.�rrzP 22 / S.F.
4 Total Lot Area i!/oT��✓cGc✓AE �f t�F�.fr�p � •
Existing Hardcover Percentage [(3}s(4) ] �
%
(Proposed Hardcover next page) �
CoV c,� C:��C,c�t Q �G� .
�a �a� �
lanuary 8,�013
Ir�Wv`�' V`�`" �
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f/�
� � City of Orono
;-��o;�;�, Hardcover Calculation Worksheet
i1,1 T` Property Address: �g�Q C,��CP ���a`'j ��'�� ���'�`'� ��tG�'�t
.\ � Date. �,�Q,,� g-2p Elsk�ve
��KF,„���,-`� Prepared by: GRo��� � � fD ri,�-rEj,��C. 6-6-�'�l C
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 1: EXISTiNG HARDCOVER
In the following table identify all items af existing hardcwer on the properry, keyed by letter to Certificate
of SLrvey(survey must accompany this form). Use as many lines as necessary to accurately depict
existing hardcover status of the properry. For Tier 1 properties,identirfy any features by letter which are
split at the 75' setback line and calculate hardcover square fockage separately for��To al�on.
Key to Hardcover Item (Describe} Length x VYdth �g uare Feet)
Surve . 24'x 30' 720 S.F.
Exam le Gara e S.F.
a a� s.F.
s i 9 s.F.
� Sio � tf 2 S.F.
p ,. 5 f F N S.F.
E ,t,,� �'.�' rt 7 S.F.
F o � S.F.
G S.F.
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� S.F.
N �' � ��'�� '� S.F.
p S.F.
p S.F.
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R S.F.
! g S.F.
T S.F.
� - S.F.
U S.F.
W S.F.
X S.F.
y S.F.
z 65 s.F. 5l(D�
1 Total Existin Hardcover
Excludable Hardcover See Cit Code Sec 78 16$4 : S F
� c. S.F.
S.F.
. S.F.
S.F.
S.F. �1'11'"
'2 Total Excludable Hardcover G y6 p S.F.
3 Net Exisdn Hardcover Subtract line{2 from line 1 � S.F.
4 Total Lot Area i!/oT/�✓cGc,r�'c� ��' t'���tr�° �r '��• ���'��� 2 z
Existing Hardcover Percer�tage [(3}�(4) ] 2�, /'9 %
(Proposed Hardcover next page) �4
���
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January 8,201 \„k��► V'
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emo
To: Finance Department
From: Chnstine Mattson, Planning Assistant ���• �
V"
CC: Street File
Date: January 19, 2016
G/L: 101-22205
Re: Escrow Refund
Building Permit numbers 2014-00411 &2015-00647 pertaining to 2980 Casco Point Road are
complete. Please refund$700 to the applicant, Jonathan 8�Amy Miller.
The following is attached:
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Jonathan &Amy Miller
2980 Casco Point Road
Wayzata, MN 55391
w:�street files\casco pt rd�2980\escrow refund 2014-00411 &2015-00647.docx
. � ✓
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2014-00411 and#2015-00647
AGREEMENT made this.� �- day of ��£"t `� � , 20 r�, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City")Jonathan&Amy Miller("Owners").
Recitals
1. A building permit application has been filed for an entry addition located at 2980 Casco Point
Road the("Subject Property"), legally described as Tract B, Registered Land Survey No. 1423, Hennepin County
Minnesota.
2. Owners request the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUtVDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit $700 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or legal
consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owners would be responsible for under a building permit application. The escrow wil! also guarantee
reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in
accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79.
The financial security may also be used by the City to eliminate any hazardous conditions associated with the
work and to repair any damage to public property or infrastructure that is caused by the work (including planning,
engineering, or legal consultant review) associated with building permit #2014-00411 and #2015-00647 if
compliance with the approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the Ciry within the fimeframe outlined in#3 above, shall issue a S#op Work Order until the Owners pay all expenses
invoiced pursuant to #3. The Ci#y may draw from the escrow account without #urther approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returnEd to the
Owners when the review has been completed and written notification is received from the Owners requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: T OF O ONO OWNER: --- - — -_J�
_ _ _ .
�
BY� '" � �...__._.�___�..
Its: �
Intemal Usa Only: O Origina!to Pianning 0 Copy to Proper#y Owner G Copy to Street Flle
BUILDING PERMIT ESCROW AGREEMENT
Orono Building Permit#2014-00411
AGREEMENT made this L'� day of °'�` , 20�, by and between the CITY OF ORONO,
a Minnesota municipal corporation ("City") Jonathan &Amy Miller("Owners").
Recitals
1. A building permit application has been filed for an entry addition located at 2980 Casco Point
Road the ("Subject Property"), legally described as Qr��,a , Hennepin
County Minnesota.
2. Owners request the City to review this application.
3. The City will commence its review of the application and incur costs associated with said review
only if the Owner establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit $700 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or legal
consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owners would be responsible for under a building permit application. The escrow will also guarantee
reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in
accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79.
The financial security may also be used by the City to eliminate any hazardous conditions associated with the
work and to repair any damage to public property or infrastructure that is caused by the work (including planning,
engineering, or legal consultant review) associated with building permit #2014-00411 if compliance with the
approved building permit is not accomplished.
3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn
send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible expenses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the
Owners when the review has been completed and written notification is received from the Owners requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses
incurred by the City exceed the amount in escrow, the City shall have the right to certify the unpaid balance to the
subject property pursuant to Minn. Stat. §§415.01 and 366.012.
CITY: CITY O ORONO OWNER:
By. �� �� l l� �
�ts: � h n.J� _ 5=2�- � �i
�#nternal Use Only: �Originai to Planning L1 Gopy to Property L3wne� �Capy#o Street Fiie
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JOHN MILLER ,
OF TRACT B, R.�.s. No. 1423 x City of Orono
HENNEPIN COUNTY, MINNESOTA N�+ �� ,i ` Planning &Zoning Pla Rpview
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S�. � LEGAL DESCRIPTION OF PREMISES:
rod 8,Regislered Land Survey No.1423,Hennepn Counry,Minnesota
O� 's wrvey shows the bamdaries of ihe above described property,and
O location of an eadsting house,drive ard otlier visible Tardoovef'thereon.
\ O Ilt dces not purpoR in show any other improvemen�w encroachmenfs.
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\ x: Nail in bladctop
DESIGrEO AEVI5i0N I SL�LE
DA1E OESCNPTqN �MERE6Y GERTIFY TMr.T THIS'UN,SPEGFIGTION,OR REI'OfiT �,t,20.
GRONBERG 8� ASSOCIATES INC. , W�PREPARmBVMEORUNUERWDIRECiSIIPERNSI0NAN0
420.15 ADJOINING HOUSES ADDED � lT7�T 1 AM A WLY 110ENSm PPOFESSIONAL ENGINEER ANO UND p^�
��wN j SURVE�'OR UNOER T}�UWS�TIE STATE OF MWNE50T0.
— ---- ---.._..--- �---------- -- CONSULTING QIGINEERS,IAND SURVEYORS.SITE PLANNERS ; Cr20-11
accxen N5 NORTH VYILLOW DRIVE,LONG WCE,MN.SS�i6 ', ,� �_, JOB N0.
—_.— -- 952173�141 , p�� y-i o•i 5 �w ucEnSE NuweErt /L 7 S: 15130
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TIC SCHEDULED
PERMIT NO. �' ���� �7 COMPLETED S��
ADDRESS 2 ra
OWNER TELEPHONE NO.
CONTRACTOR
� DESCRIPTION
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Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
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� OWNERICONTAACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANEN7
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOA �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContrac on site:
Inspector. �
White Copyflnspector's File Canary CopylSfte Notice
� �� �� DATE TIME �,/
CITY OF ORONO CALLED IN
INSPECTION OTI '(�1SCHEDULED �
PERMIT NO. ��Y �COMPLEfED
ADDRESS ��g(L -��C� J�� ��-�'
OWNER TELEPHON NO. ��3��6-Z�Z
CONTRACTOR
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Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
kJ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERfCONTRACTOR TO MEET YOU: YES_NO
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INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (952 j 249-4600
OwnerfContractor on site:
Inspector.Qr�r-�- �1
White Copylinspector's File Canary CopylSite Notice
� �° �-���-- ��.
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED
PERMIT NO.� U <<����COMPLETED
ADDRESS �-�l'�C� C�G(�,��'(,, �P-� /�
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2 OWNERlCONTtUCTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (g52) 249-460�
OwnerlCantractor on site:
Inspector: I ►�-'
White Copyllnspector's Flle Canary CopylSfte Notice
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,� �.-.``'T_`- DATE TIME ,
CITY OF ORONO cALLED IN
INSPECTION NOTICE scHE�u�Eo :- ,�.� ��
PERMIT NO. _1��� ,connP�erE�
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OWNER TELEPHONE NO. �
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Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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2 OWNERICONTFiACTOR TO MEET YOU:�YES_NO
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0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
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Ca11 for the next inspection 24 hours in advance. t952) 249-46��
OwnerlContractoronsite: � ___ _ _ _
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White Copyllnspector's Flle Canary CopylSite Notice
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INSPECTION NOTICE SCHEDULED �� �
PERMIT NO. ��� ���7 COMPLETED
ADDRESS a� �
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CONTRACTOR
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Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ ULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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